Healthcare Provider Details

I. General information

NPI: 1033621107
Provider Name (Legal Business Name): PARISKEVI KEKATOS DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date: 10/30/2017
Reactivation Date: 04/27/2018

III. Provider practice location address

8 SPINNING WHEEL LN
DIX HILLS NY
11746-5010
US

IV. Provider business mailing address

8 SPINNING WHEEL LN
DIX HILLS NY
11746-5010
US

V. Phone/Fax

Practice location:
  • Phone: 516-477-9402
  • Fax:
Mailing address:
  • Phone: 631-462-2033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number007070
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: